Request

Request form

Complete this form.

Company Name*
Your Name*
E-mail Address*
E-mail Address(Retype)*
Zip Code	( ex：999-9999 )
Country
Address1*
Address2
Telephone*	( ex：03-9999-9999 )
Fax	( ex：03-9999-9999 )
Mobile phone
Code	18209
Name	Ultrasound System
Brand	HITACHI
Model	ARIETTA 60
Endorsement number	225ABBZX00167000
Status	Recommend
Price
Comment	Application Gereral OB/GYN Cardiac Vascular
Specification & Options	YOM2017 Color Doppler PW/CW doppler Power doppler *LCD monitor
Configuration	Convex C251 Linear L55 Linear L441
Condition	Patient ready
inquiry*	(1000characters)